2020-06-04T10:25:08-05:00 2019-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2018-07-01 390806429 LANGLADE HOSPITAL - HOTEL DIEU OF ST JOSEPH OF ANTIGO WISCONSIN LANG 7156232331 112 EAST FIFTH AVENUE ANTIGO WI 54409 TYLER HACK CFO 7156232331 2020-06-01 1 MICHAEL J PETERSON CPA P01833529 2187224705 2020-06-01 71.13.38.61 2020-06-01 11:02:01 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 9747BB8E0DC0E78824B7C9EDF76D609BB7F00C05 2018 2021-01-29 14:40:06Z ASPIRUS LANGLADE HOSPITAL TYLER HACK 112 EAST FIFTH AVENUE ANTIGO WI 54409 117263984 0 X WWW.ASPIRUS.ORG X 1933 WI THE COMMUNITY BENEFIT CONTRIBUTION OF ASPIRUS LANGLADE HOSPITAL INCLUDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTH CARE AND IMPROVE HEALTH IN OUR COMMUNITIES. 9 6 599 154 374040 0 92928 55723 106958885 113932005 5836351 3139373 98909 77713 112987073 117204814 234339 406342 0 0 44392575 45863877 0 0 0 50800879 53970554 95427793 100240773 17559280 16964041 195860107 215754676 32154428 32646601 163705679 183108075 AS A MINISTRY OF JESUS WE HEAL PEOPLE, PROMOTE HEALTH, AND STRENGTHEN COMMUNITIES. 0 0 69680206 406342 113557965 ACUTE GENERAL CARE HOSPITAL WITH BOTH INPATIENT AND OUTPATIENT RELATED SERVICES ALONG WITH A HOSPICE PROGRAM. INPATIENTS - 1,238 ADMISSIONS WITH 4,070 PATIENT DAYS AND 261 BIRTHS; OUTPATIENTS - 10,630 EMERGENCY VISITS, 12,024 URGENT CARE VISITS, 29,202 IMAGING PROCEDURES, 265,212 LAB TESTS, 38,946 THERAPY TREATMENTS, AND 10,911 SPECIALTY CLINIC VISITS; SURGICAL SERVICES - 3,686 TOTAL PATIENTS TREATED; HOSPICE - 3,894 VISITS 69680206 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 101 0 599 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 9 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X TYLER HACK 7156239215 112 EAST FIFTH AVENUE ANTIGO WI 54409 MIKE WINTER CHAIRMAN 1.00 0.00 X X 0 0 0 RICK NEVERS VICE CHAIRMAN/SVP REGIONAL 1.00 50.00 X X 0 456553 79281 KRISTINE FLOWERS MD BOARD MEMBER 1.00 1.00 X 0 277371 45102 SID SCZYGELSKI BOARD MEMBER/SVP OF FINANC 1.00 50.00 X 0 654883 117668 NOEL DEEP MD BOARD MEMBER 1.00 1.00 X 0 475691 50536 CHUCK HOLLAND BOARD MEMBER (TERM 6/18/19) 1.00 0.00 X 0 0 0 MIKE OLSON DO BOARD MEMBER/PHYSICIAN RAD 40.00 0.00 X 648591 0 39527 CHARLIE ZANAYED BOARD MEMBER 1.00 0.00 X 0 0 0 ANN ROLLER BOARD MEMBER 1.00 0.00 X 0 0 0 JOHN REETZ BOARD MEMBER 1.00 0.00 X 0 0 0 PATRICK TINCHER CFO ALH 40.00 0.00 X 240841 0 38653 ANDREW BARTH CEO ALH 40.00 1.00 X 320138 0 37027 MATT HEYWOOD PRESDIENT & CEO AI 1.00 50.00 X 0 1156743 195564 CARI LOGEMANN SVP & GENERAL COUNSEL 1.00 50.00 X 0 452398 81636 JANELLE MARKGRAF DIRECTOR HR & OFF CAMPUS S 40.00 0.00 X 194838 0 29726 SHERRY BUNTEN DIRECTOR OF PATIENT CARE S 40.00 0.00 X 202566 0 36697 TODD RICHARDSON SVP & CIO 1.00 50.00 X 0 395288 88380 JOHN HEISLER SVP & CHIEF HR OFFICER 1.00 50.00 X 0 416068 40142 RUTH RISLEY-GRAY SVP NURSING, SYSTEM CNO 1.00 50.00 X 0 392122 77261 F DEAN DANNER JR TERMED 618 SVP AMBULATORY SERVICES & 1.00 50.00 X 0 386225 27706 MICHAEL MCGRAIL MD SVP SYSTEM CMO 1.00 50.00 X 0 485524 80747 ERIC ANDERSON SVP SERVICE LINE & PATIENT 1.00 50.00 X 0 334002 80130 RENEE SMITH EXECUTIVE DIRECTOR ANI 1.00 40.00 X 0 455560 45608 BESSANT PARKER ALH CMO (TERM 9/2/18) 40.00 0.00 X 283805 0 20517 DOUGLAS ARMATO MD PHYSICIAN RADIOLOGIST 40.00 0.00 X 500159 0 35152 KENNETH BOWMAN MD PHYSICIAN RADIOLOGIST 40.00 0.00 X 546511 0 32442 STACY KOLZ DIRECTOR - PHARMACY 40.00 1.00 X 155145 0 33443 LYNNE DAFOE DIRECTOR - CLINICS 40.00 0.00 X 128288 0 34402 DEBORAH KITCH PHARMACIST 40.00 0.00 X 125897 0 27952 3346779 6338428 1375299 24 0 1 0 PROGRESSIVE ANESTHESIA SOLUTIONS PO BOX 290 ANTIGO WI 54409 CLINICAL SERVICES 1043068 FOCUSONE SOLUTIONS 13609 CALIFORNIA STREET OMAHA NE 68154 CLINICAL SERVICES 859746 CHG COMPANIES INC PO BOX 972651 DALLAS TX 75397 CLINICAL SERVICES 781933 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 CLINICAL SERVICES 737035 ARAMARK UNIFORM SERVICES INC 5330 INDUSTRIAL BLVD NE SUITE 616 FRIDLEY MN 55421 CLINICAL SERVICES 489508 43 39293 14660 1770 55723 HOSPITAL SERVICES 621990 87369262 87369262 PHYSICIAN PRIMARY CARE CLINICS 621110 16855831 16855831 OTHER OPERATING REVENUE 621990 7749645 7375605 374040 ASSISTED LIVING 623000 1385673 1385673 INDEPENDENT LIVING 623990 571594 571594 113932005 3139373 3139373 136883 59170 77713 77713 77713 117204814 113557965 374040 3217086 X 406342 406342 35761300 29171829 6589471 1752400 1752400 6167625 3989529 2178096 2182552 2182552 25370 25370 14300 14300 33752 33752 25166665 11734901 13431764 199623 16944 182679 296207 156598 139609 2312934 43357 2269577 1493523 544212 949311 83081 61073 22008 105568 68515 37053 1009804 1009804 5084187 2617798 2466389 241841 89392 152449 SUPPLIES 13571900 12729861 842039 BAD DEBT EXPENSE 3348006 3348006 EQUIPMENT 343057 288751 54306 DUES AND SUBSCRIPTIONS 322126 196307 125819 318610 281839 36771 100240773 69680206 30560567 0 17769971 33162029 20106230 15911280 14439325 14779334 1871583 2133295 1091219 1422821 101661675 49333863 56066513 52327812 78437446 88530712 3950129 3953686 2127691 3533707 195860107 215754676 6346072 7490968 23935000 23450000 1873356 1705633 32154428 32646601 X 163182823 183108075 522856 0 163705679 183108075 195860107 215754676 X 16964041 2460685 -22330 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 6175 6175 0 PART II-B, LINE 1: ASPIRUS LANGLADE HOSPITAL PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING AND MATERIALS. THE WHA HAS NOTIFIED ASPIRUS LANGLADE HOSPITAL THAT APPROXIMATELY $2,868 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTH CARE ENVIRONMENT. ASPIRUS LANGLADE HOSPITAL IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, ASPIRUS LANGLADE HOSPITAL PAYS MEMBERSHIP FEES TO THE RWHC. THE RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST AND EMERGENCY ROOM PATIENT CARE COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, THE RWHC ALSO PROVIDES ANALYSIS ON CURRENT HEALTH CARE ISSUES IN AN EFFORT TO PROMOTE AND IMPROVE HEALTH CARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON THE PART OF MEMBER ORGANIZATIONS. THE RWHC DETERMINED THAT APPROXIMATELY $3,307 OF THE FEES PAID BY ASPIRUS LANGLADE HOSPITAL IN FY2019 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTH CARE ENVIRONMENT IN THE STATE OF WISCONSIN. 1382049 1382049 63184221 22718272 40465949 5381790 2483132 2898658 31352034 24132459 7219575 361581 361581 52327812 UNAMORTIZED BOND PREMIUM 689218 DEFERRED COMPENSATION 1236277 OTHER LONG-TERM LIABILITIES 32000 DEFERRED BOND ISSURANCE COSTS -251862 1705633 X 116310044 2460685 -3355455 -894770 117204814 0 117204814 96885318 59170 59170 96826148 3414625 3414625 100240773 PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE ORGANIZATION IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. THE ORGANIZATION IS ALSO ENGAGED, TO A LIMITED EXTENT, IN CERTAIN ACTIVITIES SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME (UBI). INCOME TAXES ON UBI ARE NOT SIGNIFICANT. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NET AGAINST REVENUE ON FORM 990 59,170. BAD DEBT EXPENSE -3,264,625. DONATION EXPENSE -150,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NET AGAINST REVENUE ON FORM 990 59,170. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 3,264,625. DONATION EXPENSE 150,000. 1 1 X 1 X 1 X 1 1 1 0 1 1 1027423 1027423 0.01060 12864424 9754774 3109650 0.03210 13891847 9754774 4137073 0.04270 1581154 1096320 484834 0.00500 299038 299038 0.00310 1368557 1197157 171400 0.00180 28060 28060 0.00030 3276809 2293477 983332 0.01020 17168656 12048251 5120405 0.05290 484718 347725 136993 0.00140 484718 347725 136993 0.00140 1 1469081 24606891 24465476 141415 X 1 0 1 1 ASPIRUS LANGLADE HOSPITAL 112 E 5TH AVENUE ANTIGO WI 54409 1055 X X X ASPIRUS LANGLADE HOSPITAL 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X SEE LINE 7 D FOR EXPLANATION X X 1 18 1 SEE LINE 7D FOR EXPLANATION 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X 1 X ASPIRUS.ORG/FINANCIALAID X ASPIRUS.ORG/FINANCIALAID X ASPIRUS.ORG/FINANCIALAID X X X X X X 1 X 0 X X X X 1 X 0 0 ASPIRUS LANGLADE HOSPITAL PART V, SECTION B, LINE 5: KEY INFORMANT INTERVIEWS WERE CONDUCTED, THE LISTING INCLUDES INDIVIDUALS FROM THE VARIOUS TWELVE SECTORS. (YOUTH, PARENTS, BUSINESSES, MEDIA, SCHOOLS, YOUTH SERVING ORGANIZATIONS, LAW ENFORCEMENT, RELIGIOUS/FRATERNAL ORGANIZATIONS, CIVIC OR VOLUNTEER GROUPS HEALTHCARE PROFESSIONS, STATE OR LOCAL GOVERNMENTAL AGENCIES). ALL COMMUNITY MEMBERS HAD THE OPPORTUNITY TO TAKE A PUBLIC OPINION SURVEY BY AN ONLINE LINK OR PAPER. OVER 600 COMMUNITY MEMBERS TOOK THE SURVEY THAT WAS REFERENCED ABOVE. ASPIRUS LANGLADE HOSPITAL PART V, SECTION B, LINE 6B: IT WAS COMPLETED IN COLLABORATION WITH THE LANGLADE COUNTY HEALTH DEPARTMENT. ASPIRUS LANGLADE HOSPITAL PART V, SECTION B, LINE 7D: CHNA: HTTPS://WWW.ASPIRUS.ORG/UPLOADS/PUBLIC/DOCUMENTS/CHNAS/ALH-CHNA%202019-22.PIMPLEMENTATION STRATEGY: HTTP://ASPIRUS.ORG/UPLOADS/PUBLIC/DOCUMENTS/ALH/CHNA%202016%20REPORT.PDF ASPIRUS LANGLADE HOSPITAL PART V, SECTION B, LINE 11: THE CAUSES OF COMMUNITY HEALTH PROBLEMS ARE ALL ENCOMPASSING, AND ONE AGENCY CANNOT IMPROVE THEM INDEPENDENTLY. BECAUSE OF THESE COMPLEXITIES, THESE PROBLEMS REQUIRE A SYSTEM PERSPECTIVE AND MULTI-PERSPECTIVE AND MULTI-FACETED APPROACH. THE ABILITY TO PARTNER EFFECTIVELY WITH OTHER INDIVIDUALS AND ORGANIZATIONS, BOTH INSIDE AND OUTSIDE THE COMMUNITY, IS ESSENTIAL TO DOING THE WORK OF BUILDING HEALTHY COMMUNITIES. COLLABORATING ACROSS THE COMMUNITY ALLOWS THE COMMUNITY TO 1) LEVERAGE EXISTING ASSETS IN THE COMMUNITY CREATING THE OPPORTUNITY FOR BROADER IMPACT 2) AVOID UNNECESSARY DUPLICATION OF PROGRAMS OR SERVICES THEREBY MAXIMIZING THE USES OF RESOURCES 3) INCREASE THE CAPACITY OF COMMUNITY MEMBERS TO ENGAGE IN CIVIL DIALOGUE AND COLLABORATIVE PROBLEM SOLVING TO POSITION THE COMMUNITY TO BUILD ON AND SUSTAIN HEALTH IMPROVEMENT ACTIVITIES. THE FOLLOWING TOP HEALTH PRIORITIES WERE IDENTIFIED FOR LANGLANDE COUNTY: 1. SUBSTANCE ABUSE AND MENTAL HEALTH 2. CHRONIC DISEASE PREVENTION AND MANAGEMENT 3. ACCESS AND AFFORDABILITY OF HEALTHCARE SERVICES THE STRATEGIES LISTED BELOW ARE EXAMPLES OF HOW THE HOSPITAL IS ADDRESSING TOP NEEDS IDENTIFIED. AT THIS TIME, THERE ARE NO STRATEGIES THAT HAVE BEEN ASSIGNED TO ASPIRUS LANGLADE HOSPITAL (PLEASE SEE FULL IMPLEMENTATION STRATEGY FOR COMPLETE LISTING OF COMMUNITY STRATEGIES).- SUBSTANCE ABUSE AND MENTAL HEALTH: 1. ADVANCE SOBER LIVING FACILITY PILOT PROGRAM IN LANGLADE COUNTY: ASPIRUS LANGLADE HOSPITAL HAS PLEDGED FUNDING FOR THIS INITIATIVE THROUGH THE RELIGIOUS HOSPITALLERS OF ST. JOSEPH'S MISSION FUND AND THROUGH THE COMMUNITY HEALTH FOUNDATION. 2. EXPLORE RECOVERY COACHING PRACTICES FOR THE LANGLADE COUNTY AREA: BY PARTNERING WITH THE MARSHFIELD CLINIC AMERICORPS PROGRAM, ASPIRUS LANGLADE HOSPITAL AND ASPIRUS WAUSAU HOSPITAL INTEGRATED A PILOT PROGRAM OF FOUR RECOVERY COACHES ACROSS THREE COUNTIES TO WORK WITH IDENTIFIED PATIENT POPULATIONS AND COMMUNITY MEMBERS. THE PROGRAM RUNS THROUGH AUGUST 2020 AT WHICH TIME IT WILL BE ASSESSED ON ITS SUCCESS AND MEASURES. 3. CONTINUE "WRITTEN OFF" SCREENINGS IN LANGLADE COUNTY TO FURTHER EDUCATE ON ADDICTION AND RECOVERY: ASPIRUS LANGLADE HOSPITAL HAS BEEN A PUBLIC SCREENING SITE FOR THE DOCUMENTARY AND HOSTED, ON MULTIPLE OCCASIONS, A PANEL DISCUSSION ON ADDICTION AND RECOVERY IN ADDITION WITH THE SHOWING. - ACCESS AND AFFORDABILITY OF HEALTHCARE SERVICES 1. CONTINUE PREVENTION FUND, A PROGRAM TO ASSIST PATIENTS WITH AN IMMEDIATE MEDICAL NEED WHO DO NOT HAVE FINANCIAL RESOURCES AT TIME OF SERVICE (I.E. MEDICATION, INHALERS, ETC): ASPIRUS LANGLADE HOSPITAL HAS COMMITTED $10,000 EACH YEAR TO ADDRESS IMMEDIATE NEEDS OF PATIENTS WHO CANNOT AFFORD THE MATERIALS AND OR SERVICES. EACH PATIENT AND FINANCIAL NEED IS TRACKED AND FOLLOWED UP ON THROUGHOUT ONE YEAR WITH THE GOAL TO PREVENT AND DECREASE READMISSIONS DUE TO UNMET MEDICAL NEEDS. 2. COLLABORATION WITH THE PUBLIC TRANSPORTATION SYSTEM TO INCREASE UTILIZATION OF RIDES PERTAINING TO SOCIAL DETERMINANTS OF HEALTH: WITH FUNDING PROVIDED BY THE ASPIRUS LANGLADE HOSPITAL RELIGIOUS HOSPITALLERS OF ST. JOSEPH MISSION FUND, THE NEED FOR INCREASED PUBLIC TRANSPORTATION ADDRESSED A GAP FOUND IN THE 2013 CHNA. WITH THE CONTRIBUTION OF APPROXIMATELY $117,000, HOURS, DRIVERS AND ROUTES WERE INCREASED THROUGHOUT LANGLADE COUNTY. EACH ROUTE IS TRACKED AND REPORTED ON A QUARTERLY BASIS - LOCATIONS OF INTEREST TO THE NEED INCLUDE GROCERY STORES, EMPLOYMENT, MEDICAL APPOINTMENTS, PHARMACIES, AND SOCIAL EMOTIONAL ACTIVITIES (ALL THOSE THAT PERTAIN TO THE SOCIAL DETERMINANTS OF HEALTH). - CHRONIC DISEASE PREVENTION AND MANAGEMENT: 1. CONTINUE WEEKEND BACKPACK PROGRAM WITH FAMILIES AND YOUTH: PRIMARILY FUNDED AND STAFFED WITH EMPLOYEES FROM ASPIRUS LANGLADE HOSPITAL, THIS PROGRAM CONTINUES TO ADDRESS CHILDHOOD FOOD INSECURITY WITHIN LANGLADE COUNTY. THE PROGRAM RUNS OUT OF THE FOOD PANTRY BUILDING OWNED BY THE HOSPITAL. WITHOUT THE PARTNERSHIP OF ASPIRUS LANGLADE HOSPITAL, THIS PROGRAM WOULD NOT CONTINUE TO RUN AND SERVE THE NEED IDENTIFIED IN THE COMMUNITY. EACH WEEK THROUGHOUT THE SCHOOL YEAR, APPROXIMATELY 350 CHILDREN ARE SERVED FOR 29 WEEKENDS. ASPIRUS LANGLADE HOSPITAL PART V, SECTION B, LINE 13B: THIRD PARTY SEGMENTATION AND PROPENSITY TO PAY. 5 1 - ASPIRUS ANTIGO CLINIC 110 E 5TH AVE ANTIGO WI 54409 CLINIC PROVIDING A WIDE RANGE OF OUTPATIENT SERVICES 2 - ASPIRUS BIRNAMWOOD CLINIC 400 RAILROAD BIRNAMWOOD WI 54414 CLINIC PROVIDING A WIDE RANGE OF OUTPATIENT SERVICES 3 - ASPIRUS ELCHO CLINIC W10618 CLINIC ST ELCHO WI 54428 CLINIC PROVIDING A WIDE RANGE OF OUTPATIENT SERVICES 4 - PINE MEADOWS 525 FLIGHT RD ANTIGO WI 54409 SENIOR HOUSING 5 - ROSALIA GARDENDS 525 FLIGHT RD ANTIGO WI 54409 ASSISTED LIVING PART I, LINE 7: THE COSTING METHODOLOGY USED ON FORM 990, SCHEDULE H IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST TO CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR FORM 990. PART I, LINE 7G: THE COST OF SUBSIDIZED HEALTH SERVICES ARE RELATED TO THE HOSPICE AND DIALYSIS PROGRAMS OF ASPIRUS LANGLADE HOSPITAL. ASPIRUS LANGLADE USED A COST TO CHARGE RATIO TO ESTIMATE THE COST OF EACH DEPARTMENT AND USED INTERNAL DEPARTMENT REPORTS TO DETERMINE THE DIRECT REVENUE OFFSET. THE DIALYSIS PROGRAM HAD AN ESTIMATED COST OF $1,368,557 WITH DIRECT REVENUE OFFSET OF $1,197,156. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,264,625. PART II, COMMUNITY BUILDING ACTIVITIES: WHILE THERE IS A GROWING ARGUMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT," THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. ASPIRUS LANGLADE HOSPITAL PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE HOSPITAL BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT QUANTIFIED. ASPIRUS LANGLADE HOSPITAL, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, THE HOSPITAL PROVIDES LOCAL ACCESS TO MANY OTHER HEALTH SERVICES. THE HOSPITAL'S COMMUNITY BUILDING ACTIVITIES FOCUS ON EFFORTS TO ENRICH THE LIVES OF COMMUNITY MEMBERS WHO ARE STRUGGLING WITH ISSUES THAT MAY HAVE A NEGATIVE IMPACT ON THEIR HEALTH. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY:IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, ASPIRUS LANGLADE HOSPITAL ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, ASPIRUS LANGLADE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE AMOUNTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), ASPIRUS LANGLADE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHICH ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTH CARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. ANY SHORTFALL IS TREATED AS A COMMUNITY BENEFIT SINCE THE HOSPITAL IS PROVIDING SERVICES AT A LOSS WHICH ARE ESSENTIAL TO THE COMMUNITY. THE AMOUNTS OF MEDICARE ALLOWANCE COSTS ARE DETERMINED USING THE PRINCIPLES OF MEDICARE REIMBURSEMENT. PART III, LINE 9B: UPON A PATIENT'S APPROVAL FOR FINANCIAL ASSISTANCE, THIS IS LOADED AS AN INSURANCE COVERAGE TO THE PATIENTS ACCOUNT WITH AN EFFECTIVE AND TERMINATION DATE TO ASSURE CAPTURING ALL CHARGES FOR THE PATIENT FOR ADJUSTMENT IN A WORK QUEUE PRIOR TO ANY REMAINING BALANCE BEING MOVED TO PATIENT LIABILITY AND THEREFORE PREVENTING UNDISCOUNTED SERVICES FROM BEING BILLED TO A PATIENT. PART VI, LINE 2: KEY INFORMANT INTERVIEWS, COMMUNITY SURVEY, HEALTH AND SOCIAL DATA AND TRENDS TO DETERMINE WHETHER THERE IS AN UNMET NEED WITHIN THE COMMUNITY. PART VI, LINE 3: ALL PATIENT STATEMENTS PROVIDE INFORMATION REGARDING THE ASPIRUS FINANCIAL AID PROGRAM. THIS INCLUDES A TELEPHONE NUMBER TO REQUEST IN-PERSON ASSISTANCE, INFORMATION ABOUT THE PROGRAM AS WELL AS TO REQUEST AN APPLICATION. THE STATEMENT ALSO PROVIDES THE WEB ADDRESS WHICH DIRECTS PATIENTS TO OUR FINANCIAL AID POLICY AS WELL AS THE APPLICATION AND PLAIN LANGUAGE SUMMARY. LETTERS FROM CENTRAL BILLING OFFICE STAFF INFORM PATIENTS THAT ASPIRUS HAS A FAP. THE FAP IS OFFERED AT THE TIME OF REGISTRATION ANNUALLY TO ALL PATIENTS. FINANCIAL COUNSELORS OFFER FAP TO PATIENTS DURING COLLECTION CALLS. ASPIRUS HAS CERTIFIED APPLICATION COUNSELORS THAT ARE AVAILABLE TO ASSIST WITH MARKETPLACE ENROLLMENT AT WELL AS MEDICAL ASSISTANCE APPLICATIONS. CARDON OUTREACH IS USED TO REVIEW ALL PATIENTS THAT ARE INPATIENT OR PRESENT TO THE ED TO ASSIST WITH MEDICAL ASSISTANCE APPLICATIONS. PART VI, LINE 4: ASPIRUS LANGLADE HOSPITAL SERVES THE POPULATION OF LANGLADE COUNTY AND SURROUNDING COUNTIES. LANGLADE COUNTY IS A RURAL COUNTY WITH NO TOWNS OF ANY SIGNIFICANT SIZE. THE POPULATION IS AGING AND PROJECTIONS INDICATE 50% OF THE POPULATION WILL BE OVER 64 YEARS OF AGE BY 2019. VERY LITTLE GROWTH IS PROJECTED FOR THE SERVICE AREA IN THE COMING YEARS. LANGLADE COUNTY HAS TRADITIONALLY SEEN HIGH RATES OF UNEMPLOYMENT. THERE ARE NO OTHER HOSPITALS IN THE IMMEDIATE AREA THAT SERVE LANGLADE COUNTY. THERE ARE HOSPITALS IN RHINELANDER AND IN WAUSAU; HOWEVER, DEPENDING UPON LOCATION IN LANGLADE COUNTY, THESE FACILITIES WOULD BE FAIRLY FAR AWAY. PART VI, LINE 5: THE BOARD OF DIRECTORS IS COMPRISED OF 9 INDIVIDUALS FROM THE SURROUNDING AREA. OF THESE 10 BOARD MEMBERS, 6 ARE INDEPENDENT. THE HOSPITAL DOES EXTEND PRIVILEGES TO ALL QUALIFIED LOCAL PHYSICIANS. THE HOSPITAL PARTICIPATES IN LOCAL HEALTH FAIRS AND PROVIDES FREE SCREENINGS THROUGH THESE HEALTH FAIRS. PART VI, LINE 6: ASPIRUS LANGLADE HOSPITAL IS A PARTNER WITH ASPIRUS, INC. (ASPIRUS) A MULTI-SPECIALTY HEALTH SYSTEM WITH A BASE LOCATION IN WAUSAU, WISCONSIN. LANGLADE HOSPITAL WORKS WITH ASPIRUS TO PROMOTE HEALTH AND WELLNESS INITIATIVES IN THE COMMUNITIES THEY SERVE. A NUMBER OF REPRESENTATIVES FROM ASPIRUS HAVE ROLES ON THE BOARD OF DIRECTORS OF LANGLADE HOSPITAL AND TOGETHER PROMOTE THE MISSION OF ASPIRUS. ASPIRUS IS AN INTEGRATED, COMMUNITY-GOVERNED HEALTH CARE SYSTEM, WHICH LEADS BY ADVANCING INITIATIVES TO IMPROVING THE HEALTH OF ALL IT SERVES. ASPIRUS WORKS COLLABORATIVELY WITH OTHERS WHO SHARE ITS PASSION FOR EXCELLENCE AND COMPASSION FOR PEOPLE. ASPIRUS AND LANGLADE HOSPITAL WORK COLLABORATIVELY TO STREAMLINE PROCESSES TO CONTINUE TO PROVIDE HIGH QUALITY CARE TO MEMBERS OF COMMUNITIES WHICH OTHERWISE WITHOUT THE EFFORTS OF A COMBINED PARTNERSHIP MAY NOT HAVE ACCESS TO THIS CARE LOCALLY. PART VI, LINE 7, REPORTS FILED WITH STATES WI 1 MENOMINEE INDIAN TRIBE OF WISCONSIN PO BOX 910 KESHENA WI 54409 391205576 119999 RED ROBIN/MENOMINEE TRANSIT SERVICES MEMORIAL HOSPITAL AND COMMUNITY HEALTH FOUNDATION INC 112 E 5TH AVE ANTIGO WI 54409 391304761 501(C)(3) 22119 OTHER WAGES AND BENEFITS INKIND FOR ACCOUNTING AND MANAGEMENT SERVICES BOYS AND GIRLS CLUB OF LANGLADE COUNTY 411 SUPERIOR ST ANTIGO WI 54499 391980025 501(C)(3) 65600 EXPENSES FOR ONGOING ACTIVITIES/ FOOD FOR CHILDREN CITY OF ANTIGO 700 EDISON STREET ANTIGO WI 54409 396005380 25000 TRAIL EXPANSION PROJECT ASPIRUS HEALTH FOUNDATION INC 425 PINE RIDGE BLVD WAUSAU WI 54401 391256656 501(C)(3) 150000 FAMILY HOUSE CONTRIBUTION 5 0 PART I, LINE 2: THE ORGANIZATION PROVIDES BOARD APPROVED CAPITAL DISTRIBUTIONS, WAGES AND BENEFITS TO RELATED ENTITIES AND NON-RELATED ENTITIES; NO FORMAL MONITORING IS REQUIRED. X 1 0 X X X X X 0 1 0 0 0 0 0 0 0 RICK NEVERS VICE CHAIRMAN/SVP REGIONAL 0 356162 0 55425 0 44966 0 16506 0 62775 0 535834 0 38383 KRISTINE FLOWERS MD BOARD MEMBER 0 270819 0 0 0 6552 0 12736 0 32366 0 322473 0 0 SID SCZYGELSKI BOARD MEMBER/SVP OF FINANC 0 514118 0 87791 0 52974 0 16506 0 101162 0 772551 0 49137 NOEL DEEP MD BOARD MEMBER 0 469215 0 0 0 6476 0 16506 0 34030 0 526227 0 0 MIKE OLSON DO BOARD MEMBER/PHYSICIAN RAD 637899 0 5084 0 5608 0 8250 0 31277 0 688118 0 0 0 PATRICK TINCHER CFO ALH 209422 0 26506 0 4913 0 6637 0 32016 0 279494 0 0 0 ANDREW BARTH CEO ALH 269002 0 50405 0 731 0 7935 0 29092 0 357165 0 0 0 MATT HEYWOOD PRESDIENT & CEO AI 0 869672 0 267317 0 19754 0 16506 0 179058 0 1352307 0 0 CARI LOGEMANN SVP & GENERAL COUNSEL 0 372200 0 58440 0 21758 0 16506 0 65130 0 534034 0 19856 JANELLE MARKGRAF DIRECTOR HR & OFF CAMPUS S 168486 0 21039 0 5313 0 5314 0 24412 0 224564 0 0 0 SHERRY BUNTEN DIRECTOR OF PATIENT CARE S 178871 0 22680 0 1015 0 5585 0 31112 0 239263 0 0 0 TODD RICHARDSON SVP & CIO 0 297875 0 56000 0 41413 0 16506 0 71874 0 483668 0 38563 JOHN HEISLER SVP & CHIEF HR OFFICER 0 304853 0 56609 0 54606 0 16506 0 23636 0 456210 0 40214 RUTH RISLEY-GRAY SVP NURSING, SYSTEM CNO 0 286934 0 52327 0 52861 0 16506 0 60755 0 469383 0 45015 F DEAN DANNER JR TERMED 618 SVP AMBULATORY SERVICES & 0 161114 0 111152 0 113959 0 14413 0 13293 0 413931 0 66173 MICHAEL MCGRAIL MD SVP SYSTEM CMO 0 400085 0 73833 0 11606 0 14262 0 66485 0 566271 0 0 ERIC ANDERSON SVP SERVICE LINE & PATIENT 0 274871 0 45840 0 13291 0 15344 0 64786 0 414132 0 11262 RENEE SMITH EXECUTIVE DIRECTOR ANI 0 348984 0 64382 0 42194 0 16506 0 29102 0 501168 0 33431 BESSANT PARKER ALH CMO (TERM 9/2/18) 246038 0 37450 0 317 0 6567 0 13950 0 304322 0 0 0 DOUGLAS ARMATO MD PHYSICIAN RADIOLOGIST 492753 0 84 0 7322 0 8250 0 26902 0 535311 0 0 0 KENNETH BOWMAN MD PHYSICIAN RADIOLOGIST 537863 0 84 0 8564 0 8250 0 24192 0 578953 0 0 0 STACY KOLZ DIRECTOR - PHARMACY 154742 0 78 0 325 0 4805 0 28638 0 188588 0 0 0 LYNNE DAFOE DIRECTOR - CLINICS 127653 0 80 0 555 0 4025 0 30377 0 162690 0 0 0 DEBORAH KITCH PHARMACIST 125719 0 76 0 102 0 4052 0 23900 0 153849 0 0 0 PART I, LINE 1A TRAVEL FOR COMPANIONS, WHEN APPLICABLE, WAS ADDED TO THE INDIVIDUAL'S COMPENSATION AT FAIR MARKET VALUE. M. HEYWOOD - $177 S. SCZYGELSKI - $273 E. ANDERSON - $237 R. NEVERS - $273 R. RISLEY-GRAY - $199 J. HEISLER - $177 R. SMITH - $135 A. BARTH - $267 S. BUNTEN - $199 PART I, LINE 4B SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: S. SCZYGELSKI $ 49,137 R. NEVERS $ 38,383 T. RICHARDSON $ 38,563 R. RISLEY-GRAY $ 45,015 C. LOGEMANN $ 19,856 R. SMITH $ 33,431 E. ANDERSON $ 11,262 J. HEISLER $ 40,214 D.DANNER $66,173 KEY EMPLOYEES OF THE ORGANIZATION OR A PARTICIPATING AFFILIATE ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. THE PLAN YEAR IS JANUARY 1 TO DECEMBER 31ST. EMPLOYER CONTRIBUTIONS: THE CONTRIBUTION MADE BY THE EMPLOYER IS A THREE-TIERED STRUCTURE DEPENDING UPON THE EXECUTIVE'S POSITION, WHICH ARE AS FOLLOWS: 9% FOR VICE PRESIDENT, 13% FOR SENIOR LEADERSHIP COUNCIL, AND 15% FOR THE CEO. IF A PARTICIPANT TERMINATES DURING THE YEAR, THE PARTICIPANT'S EXECUTIVE ALLOWANCE IS PRORATED BASED ON THE NUMBER OF FULL CALENDAR MONTHS FROM THE BEGINNING OF THE PLAN YEAR TO THE BEGINNING OF THE CALENDAR YEAR MONTH CLOSEST TO THE CHANGE OR TERMINATION OF EMPLOYMENT. DISTRIBUTIONS: CONTINUATION OF EMPLOYMENT THROUGH THE DEFERRED VESTING DATE; THE DATE ON WHICH THE PARTICIPANT'S EMPLOYMENT IS TERMINATED AS A RESULT OF DEATH OR DISABILITY; THE DATE ON WHICH THE PARTICIPANT INCURS AN INVOLUNTARY SEPARATION FROM SERVICE WITHOUT REASONABLE CAUSE; OR THE DATE THAT IS 24 MONTHS FOLLOWING THE PARTICIPANT'S SEPARATION FROM SERVICE, BUT ONLY IF THE PARTICIPANT'S INTEREST HAS NOT BEEN FORFEITED FOR COMPETITION DURING SUCH 24 MONTH PERIOD AND THE PARTICIPANT HAS NOT ENGAGED IN COMPETITION AFTER HIS OR HER SEPARATION FROM SERVICE AND PRIOR TO HIS OR HER DEATH, THE PARTICIPANT SHALL BE VESTED AT HIS OR HER DATE OF DEATH. A WI HEALTH & EDUCATION FACILITIES AUTHORITY 391337855 2013-04-12 27000592 CONSTRUCT, RENOVATE, AND EQUIP FACILITIES 0 0 0 A 2680000 27000592 2013 0 0 1 1 A 0 0 1 0 0 0.00200 0.00200 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 PART VI THE PROCEEDS OF THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE BONDS, SERIES 2013 (ASPIRUS, INC. OBLIGATED GROUP) WERE BORROWED BY THE FOLLOWING ORGANIZATIONS: ASPIRUS WAUSAU HOSPITAL, INC. (EIN 39-1138241); ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. (EIN 39-0964813); ASPIRUS GRAND VIEW (EIN 38-2908586); AND LANGLADE HOSPITAL HOTEL DIEU OF ST. JOSEPH OF ANTIGO WISCONSIN (EIN 39-0806429). INFORMATION REGARDING THE SERIES 2013 BONDS IS REPORTED IN THE SCHEDULE K FOR EACH ORGANIZATION. [THE INFORMATION REPORTED IN PART I, PART II AND PART III RELATES ONLY TO THE PORTION OF THE SERIES 2013 BONDS LOANED TO THE ORGANIZATION. THE INFORMATION REPORTED IN PART IV RELATES TO THE ENTIRE ISSUE OF THE SERIES 2013 BONDS.] PART III - LINE 3 AND 3B ASPIRUS, INC., A MEMBER OF ASPIRUS LANGLADE HOSPITAL, HAS A POLICY AND PROCEDURES IN PLACE TO REVIEW MANAGEMENT AND SERVICE CONTRACTS TO IDENTIFY AGREEMENTS THAT MAY RESULT IN PRIVATE BUSINESS USE OF BOND-FINANCE PROPERTY. ON A CONTRACT BY CONTRACT BASIS, ASPIRUS, INC. WILL SEEK HELP FROM BOND COUNSEL AS MANAGEMENT DEEMS NECESSARY. PART III - LINE 9 SUPPLEMENTAL INFORMATION ON TAX EXEMPT BONDS: POLICY STATES THAT WE WILL SEEK BOND COUNSEL OPINION ON ALL REMEDIAL ACTIONS. MAUREEN WINTER FAMILY MEMBER OF MIKE WINTER, BOARD MEMBER 34322 EMPLOYMENT COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 6 THE HOSPITAL HAS TWO MEMBERS, THE RELIGIOUS HOSPITALLERS OF ST. JOSEPH HEALTH CORPORATION (55%) AND ASPIRUS, INC. (45%). FORM 990, PART VI, SECTION A, LINE 7A SEE EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7B. FORM 990, PART VI, SECTION A, LINE 7B THE HOSPITAL OPERATES UNDER THE CONTROL AND DIRECTION OF THE RELIGIOUS HOSPITALLERS OF ST. JOSEPH HEALTH CORPORATION (RHSJ), A RELIGIOUS CONGREGATION OF THE ROMAN CATHOLIC CHURCH AND ASPIRUS, INC. EACH OF WHICH APPOINT 3 BOARD MEMBERS AND JOINTLY APPROVE THE REMAINING MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B THE ACCOUNTING DEPARTMENT ACCUMULATES ALL 990 AND 990-T INFORMATION, INCLUDING THE UBI CALCULATIONS. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 AND THE 990-T ARE REVIEWED BY OTHER SENIOR MANAGEMENT PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE AND ARE MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH DIRECTOR'S DESK OR OTHER MEANS OF ELECTRONIC RETRIEVAL. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS AND ALL MANAGERS ARE REQUIRED TO SIGN BIANNUAL CONFLICT OF INTEREST STATEMENTS. THE HOSPITAL'S CEO AND BOARD CHAIR REVIEW THE STATEMENTS AND HIGHLIGHT POTENTIAL CONFLICTS. THE BOARD DETERMINES ON A CASE BY CASE BASIS ANY ACTIONS REQUIRED. INDIVIDUALS ARE NOT PERMITTED TO VOTE ON ANY TRANSACTION WHERE A CONFLICT HAS BEEN DETERMINED TO EXIST. ALL CONFLICTS AND PROCEEDINGS ARE NOTED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 FOR PURPOSES OF DETERMINING COMPENSATION, ASPIRUS LANGLADE HOSPITAL RELIED ON RELATED ORGANIZATIONS TO ESTABLISH THE COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, NOR ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G LAB PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 933,768. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 933,768. PROVIDER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 5,211,293. MANAGEMENT AND GENERAL EXPENSES 31,725. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,243,018. LAUNDRY PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 61,117. MANAGEMENT AND GENERAL EXPENSES 256,900. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 318,017. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 1,229,928. MANAGEMENT AND GENERAL EXPENSES 129,031. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,358,959. CORPORATE ALLOCATION: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 12,754,450. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,754,450. PHARMACY DISPENSING FEES: PROGRAM SERVICE EXPENSES 1,678,106. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,678,106. RECRUITMENT: PROGRAM SERVICE EXPENSES 74,478. MANAGEMENT AND GENERAL EXPENSES 28,393. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 102,871. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,546,211. MANAGEMENT AND GENERAL EXPENSES 231,265. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,777,476. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION -22,330. FORM 990, PART XII, LINE 2C, AUDIT PROCESS: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. RELIGIOUS HOSPITALLERS OF ST JOSEPH HEALTH CORP 411 E WIS AVE STE 700 MILWAUKEE WI 53202 271341591 HEALTH CARE WI 501(C)(3) LINE 1 N/A 0 ASPIRUS INC 333 PINE RIDGE BLVD WAUSAU WI 54401 391328331 HEALTH CARE WI 501(C)(3) LINE 12B, II N/A 0 0 1 1 1 1 0 0 0 1 0 0 1 1 1 1 1 1 0 0 ASPIRUS INC L 12754450 ASPIRUS INC O 18829131 ASPIRUS INC Q 151853 ASPIRUS INC P 705386 ASPIRUS HEALTH FOUNDATION B 150000 SCHEDULE R, PART V, LINE 1D ALL OUTSTANDING GROUP DEBT IS GUARANTEED BY ALL MEMBERS OF THE OBLIGATED GROUP